L.B.F. 2016-2 Application for Compensation and Reimbursement of Expenses UNITED STATES BANKRUPTCY COURT FOR THE EASTERN DISTRICT OF PENNSYLVANIA In re: ) Chapter )))Debtor ) Bky. No. ................... APPLICATION FOR first, second, etc. as applicable COMPENSATION AND REIMBURSEMENT OF EXPENSES Of..................................................... name of applicant, professional capacity For..................................................... entity represented or engaged by For THE PERIOD ................ THROUGH ................ ................................................................................ in accordance Name of applicant, professional capacity, and entity represented or engaged by with F.R.B.P. 2016 applies under 247 330 of the Code for an award of compensation and reimbursement of actual, necessary expenses and represents: Part A Preliminary Statement 1.Applicant is [professional capacity] for [entity represented or engaged by]. 2.All services rendered and expenses incurred for which compensation or reimbursement isrequested were performed or incurred for or on behalf of [entity represented or engagedby]. 3.The services described in this Application are actual, necessary services and thecompensation requested for those services is reasonable. 4.The expenses described in this Application are actual, necessary expenses. American LegalNet, Inc. www.FormsWorkFlow.com [Additional numbered paragraphs may be used by the Applicant to set forth other statements or information.] Part B General Information 1.Period xx/xx/xx to xx/xx/xx Final Application Interim Application Requested Fees $ Expenses $ Total $ 2.General Information a.Date case filed: xx/xx/xx b.Date application to approve employment filed: xx/xx/xx c.Date employment approved: xx/xx/xx d.First date services rendered in the case: xx/xx/xx e.Compensation request is under 247 330: Yes NoIf other statutory basis, specify: 247 f.Any fees awarded will be paid from the estate: Yes No If no, state the source of payment of any fee that is awarded. g.This application is for a period less than 120 days after the filing of the caseor less than 120 days after the end of the period of the last application. Yes No If yes, state date and terms of court order allowing filing at shortened intervals. Order date: xx/xx/xx Terms, if any, American LegalNet, Inc. www.FormsWorkFlow.com 3.Prior Applications First Application Periodxx/xx/xx to xx/xx/xx Date of Order xx/xx/xx Requested Allowed Paid Due Fees $ $ $ $ Expenses $ $ $ $ Second Application Period xx/xx/xx to xx/xx/ Date of Order xx/xx/ Requested Allowed Paid Due Fees $ $ $ $ Expenses $ $ $ $ Grand Totals $ $ $ $ 4.Attorneys' Billing for Current Period Name Admitted Hours Billing Rate Total $ etc. etc. etc. etc. etc. Grand Total$ 5. Paralegals Billing for Current Period Name Hours Billing Rate Total Grand Totals $ 6.Billing Rates a.Are any of the billing rates different than the billing rates set forth in your lastapplication? Yes No American LegalNet, Inc. www.FormsWorkFlow.com b.If yes, indicate whose billings rates are different and explain why? Part C Billing Summary 1.Description of Services. Provide adequate detail appropriate for the amount of timebilled and the nature and variety of the services rendered. 2.Detail of Hours Expended. Set forth in list form or attach a list that shows the name ofthe professional or paraprofessional, date, activity, and time expended. The list may beorganized in either of two ways. a.By each professional or paraprofessional in chronological order for the applicationperiod; or b.By day in chronological order showing all professionals or paraprofessionals thatbilled time on a particular day during the application period.* * * * * * * Category Reporting. If category reporting of time expended is required under L.B.R. 2016-3(c), only categories for which services were rendered during the period covered by the application should be included. A separate Description of Services and Detail of Hours Expended shall be provided for each category. Part D Expense Summary Set forth in list form or attach a list that shows the type of expenses for which reimbursement is sought. For each type of expense either a.State the amount of the expense that is calculated using the applicant222s in-houseactual cost or the actual amount billed by a third party provider, or b.Explain how the amount of the expense is calculated. WHEREFORE, Applicant requests an award of $ in compensation and of $ in reimbursement of actual, necessary expenses. Date: Signed: [Applicant222s name] 205205205205205205205205205 [Firm Name] 205205205205205205205205205205205.. [Address] 205205205205205205205205205205205205... [Phone No.] 205205205205205205205205205205205... [Fax No.] 205205205205205205205205205205205205... [E-mail address] 205205205205205205205205205205 American LegalNet, Inc. www.FormsWorkFlow.com